Employee Information Form
Central Public Works Deptt.
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Zone…………………... ………………………………
Circle ……… …………………..Division
(ALL ENTRIES IN THE FORM BE MADE IN CAPITAL LETTERS ONLY)
Personal & Initial Appointment
A. OFFICE ADDRESS
1. Office Address a. Region : NR/SR/ER/WR/HQ
b. ADG : ……………………..
c. Zone : ……………………..
d. Circle : ……………………..
e. Division : …………………….
B. STAFF CATEGORY
1 Accounts
2. Tick () the option
2 Architectural
3 Drawing Staff
4 Engineering
5 Group D
6 Horticulture
7 Ministerial
8 Stenographer
9 Work Charged
C. PERSONAL DATA
3. Name:
First Name…………………Middle Name………………………..Last name………..................
4. Date of Birth (dd/mm/yy) ………/…………/…………
5. Father/Husband Name Shri ………………………………
6. Gender [Tick () the option] a. MALE b. FEMALE
7. Marital Status [Tick () the option] a. Unmarried b.Married
D. DETAILS OF INITIAL APPOINTMENT
8. Initially Appointed as equivalent to …………………………………….
[For the example of an engineering Staff:
A person might have joined as ‘Sectional
Officer (C)’ but information is to be
furnished as equivalent to ‘Junior Engineer(C)’]
9. Initial Joining Date …………………………………….
E. CURRENT POSTING DETAILS
10. Present Designation ………………………….………………..
11. Present Pay Scale ………………………….………………..
12. Post Held at present ………………………….………………..
Signature of the Employee………………...
Name of the Employee…………………………
Employee Information Form
Central Public Works Deptt.
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13. Status of present appointment a. Regular
[Tick () the option] b. Ad-hoc
c. Temporary
14. Nature of Job Engineering Staff a)Field b) Planning
[Tick () the option] CPWD-Ministerial Staff a) Acctts Br b) Corresp. Br.
15. Cadre a. CPWD Cadre
[Tick () the option] b. Delhi Administration Secretariat Service ( DASS)
c. Delhi Admin Accounts Service (DAAS)
d. Central Govt Accounts Service
e. Central Secretariat Service (CSS)
f. Central Secretariat Stenographer Service (CSSS)
g. Central Secretariat Clerical Service (CSCS)
h. Central Engineering Service (Gr.A) (CES Gr.A)
i. Central Engineering Service (Gr. B) (CES Gr. B)
j. Central Architectural Service (Gr. A) (CAS Gr. A)
k. Central Architectural Service Gr.B) (CAS Gr. B)
l. Central Electrical & Mechanical Engg Service (Gr.A) (CEMES Gr A)
m. Central Electrical & Mechanical Engg Service (Gr.A) (CEMES Gr B)
16. Station of Posting
17. Date of Joining the Current Office …………………..(dd/mm/yyyy)
18. If Posted in Delhi PWD a) YES/NO If Yes, Date since when : …/……/…….
19. Name of Subdivision, if any …………………………………..
(For field Divisions only)
……………………………………
20. Reference to the Orders of Posting
……………………………………
F. RESIDENTIAL ADDRESS DETAILS:
21. Present Address Street Address………………………………….
City …………………………………..
State …………………………………..
PIN …………………………………..
22. Permanent Address Street Address………………………………….
City …………………………………..
State …………………………………..
PIN …………………………………..
G. OTHER CONTACT DETAILS:
23. Telephone No (Office): STD Code:…………Tel No ………………
(Res): STD Code:…………Tel No ………………
(Mobile): Tel No ………………………………………
24. E-mail, if any ………………@……………………………
Signature of the Employee………………...
Name of the Employee…………………………
Employee Information Form
Central Public Works Deptt.
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H. CLASSIFICATION DETAILS FOR RESERVATION IN SERVICE
25. Category (Tick () the category Gen /SC /ST /OBC/Kashmiri Migrant
which applies to you)
26. Ex-Service man (Tick () the .……..YES/NO…………...….
appropriate option)
27. Physical Disability ……..Ortho/Blind/Mute or Deaf……
(To be filled by candidate …Percentage Disability………%
appointed under handicapped
quota only)
I. ACADEMIC QUALIFICATIONS:
28. Essential Minimum Qualification a. Graduate
(Tick () the appropriate category) b. Under Graduate
c. Under Matric
29. Essential Qualification Details ………………………………………….
(e.g. B.Sc.(Civil Engg), B.Com (Hons), Dip in Civil Engg, etc)
30. Additional Qualifications
Additional Qualification Qualification Details
(e.g. Doctorate, Above Post Graduate, Post Graduate (e.g. B.Sc.(Civil Engg), B.Com (Hons), Dip in
Graduate, Under Graduate, Under Matric Civil Engg, etc)
Signature of the Employee………………...
Name of the Employee…………………………
Employee Information Form
Central Public Works Deptt.
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31. Specialisation.(For Group ‘A’ officers only) Maximum three fields to be selected only based on their past experience
and/or qualification in order of priority)
Specialisation Details
1.
2.
3.
Note: Only following categories of specialization shall be given. If not available in the
following list, ‘Others’ shall be selected with details to be given mandatorily:-
CIVIL ELECT ARCHITECTURAL HORTICULTURE
Geo-Technical Engg. Air conditioning Information Technology Building Maintenance
New Materials &
Technologies Building Maintenance Interior Design Floral Design
Shuttering & Scaffolding Bulk Services Landscaping Landscaping
Cement & Concrete
Technology Construction Machinery Low-rise Buildings Lawn Development
Construction Safety, Health Personnel/Human Resource
Bridges & Flyovers & Environment Monumental Buildings Management
Low-rise Buildings Information Technology Multi-storeyed Buildings Road Maintenance
New Materials &
Multi-storeyed Buildings Lift & Escalators etc. Technologies Others
Personnel/Human Resource
Construction Machinery Lighting Management
Public
Information Technology Multi-storeyed Buildings Buildings(Infrastructure)
New Materials & Structural Repairs,
Bulk Services Technologies Renovation & Retrofitting
Personnel/Human Resource
Techno-Legal Management Others
Monumental Buildings Quality Assurance
Quality Assurance Road Maintenance
Structural Repairs,
Renovation & Retrofitting Shuttering & Scaffolding
Road Construction Techno-Legal
Road Maintenance Others
Building Maintenance
Construction Safety, Health
& Environment
Human Resource
Development/Management
Others
Signature of the Employee………………...
Name of the Employee…………………………
Employee Information Form
Central Public Works Deptt.
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J. POSTING DETAILS
32. Posting Record (Start from the last posting and backwards )
S.No. Station Post Pay Office Name
of Held Scale
Posting
(dd/mm/yy)
(dd/mm/yy)
Field/Plg
Division
of
CB/AB
Region
Circle
From
ADG
Posting
Zone
To
1
Note: Add additional rows or sheets as may be necessary to complete the details.
K. TRAINING DETAILS
33. Training Courses (Start from the latest training course attended and backwards )
S.no Name of Training From To Remarks Whether If abroad,
Training Place (dd/mm/yy) (dd/mm/yy) Inland or name of
Course abroad country
1.
2.
3.
4.
Note: Add additional rows or sheets as may be necessary to complete the details.
L. SEMINAR DETAILS
34. Seminar Attended (Start from the latest Seminar attended and backwards )
S.no Name of Training From To Remarks Whether If abroad,
Seminar Place (dd/mm/yy) (dd/mm/yy) Inland or name of
abroad country
1.
2.
3.
4.
5.
Note: Add additional rows or sheets as may be necessary to complete the details.
Signature of the Employee………………...
Name of the Employee…………………………
Employee Information Form
Central Public Works Deptt.
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M. SALARY DETAILS
35. Salary Details :
PAYMENTS:
A. Present Pay Scale……………………………..
B. Present Basic…………………………………
C. Increment Date………………………………..
D. GPF A/c No …………………………………
E. Govt Vehicle Facility:…………………..Yes/No
F. Govt House Allotted…………………….Yes/No
G. Gazetted ………………………………...Yes / No
H. Special Pay (If any)……………………...
I. Personal Pay, if any………………………
J. Washing Allowance, if any..………………
K. Medical Allowance, if any………………..
L. Additional Allowance, if any…………………… Rs Details ……………
M. Additional Allowance, if any…………………… Rs Details……………
DEDUCTIONS:
N. GPF Deduction……………………………………Rs.
O. CGEIS Deduction…………………………………Rs
P. CGHS Subscription……………………………….Rs
Q. DGHS Subscription………………………………Rs.
R. PM’s Relief Fund…………………………………Rs
S. Income Tax Deduction…………………………….Rs.
T. Miscellenous Deduction……………………………Rs Details……………..
LICENSE FEE:
Govt House No……………
Address……………………
Allotment Date……………
License Fee………………
Water Charges………….
Electric Charges…………
ADVANCES (LOANS) WITHOUT INTEREST
Loan Description………………….
Loan Date………………………….
Date from Deductions effected……
Sanctioned Loan Amount…………
Total Number of Installments…….
EMI…………………………………
Current Installment Number……..
ADVANCES (LOANS) WITH INTEREST:
Loan Particulars:
Loan Description…………………..
Loan Date………………………….
Sanctioned Amount……………….
Total Number of Installments……
Signature of the Employee………………...
Name of the Employee…………………………
Employee Information Form
Central Public Works Deptt.
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Principal Amount Recovery:
EMI (Principal)……………………
Total Number of Installments…….
Date from Deductions effected……
Current Installment Number……..
Interest Amount Recovery:
Total Interest Amount…………….
EMI (Interest)……………………..
Total Number of Installments……
Date from Deductions effected……
Current Installment Number……..
I certify that the foregoing information is correct to the best of my knowledge and belief.
Signature of the Employee………………...
Name of the Employee…………………………
Date ……………………………
Crosschecked from Service Records
Signature of Office Incharge.
Name of Office Incharge
with Designation
Date …………………
( With SEAL )
Signature of the Employee………………...
Name of the Employee…………………………